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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cardiovascular functions were evaluated beat by beat during 29 spontaneous deep breaths in three conscious dogs. When pleural pressure was significantly lower than during quiet breathing, stroke volume was reduced, heart rate elevated, as well as transmural pressure in the pulmonary artery (PPA-Ppl) and in the thoracic aorta (PAO-Ppl); the left ventricular filling pressure (LVEDP-Ppl) did not decrease. The authors suggest that these findings are not consistent with the classical hypothesis which explains the decrease in left ventricular output primarily by a reduction in the venous return to the left heart. The results indicate that the decrease in pleural pressure is responsible for an increase in the afterload on the left heart and suggest that this is the predominate factor in the reduction of the stroke volume without decrease in left ventricular filling pressure.
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PMID:Cardiovascular changes in conscious dogs during spontaneous deep breaths. 117 May 47

A 54-year-old non-right-handed man with positive familial sinistrality showed a pure right hemisphere syndrome following a left hemisphere stroke. Severe right side hemineglect, transcortical motor dysprosodia, spatial dysgraphia and visuo-constructive impairments were observed. At no time were the expected left hemisphere abnormalities such as aphasia, alexia, right-left disorientation or finger agnosia noted. A left fronto-temporal subcortical lesion was documented on CT scan. A Tc-99m HM-PAO SPECT study revealed no cerebral blood flow changes in the right hemisphere while in the left hemisphere a fronto-temporo-parietal cerebral blood flow reduction was evident. This case of a complete reversed laterality of cognitive functions argues for a distinction to be made between 'anomalous' cerebral dominance and 'atypical' cerebral dominance.
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PMID:Reversed laterality of cerebral functions in a non-right-hander: neuropsychological and spect findings in a case of 'atypical' dominance. 173 72

Twenty-two patients with completed stroke were studied to evaluate the clinical usefulness of three-dimensional (3D) surface display in brain imaging with Tc-99m HM-PAO. Perfusion defects were seen by standard 3D surface display in all 13 patients, with low density areas (LDA) extending to the cerebral cortex on X-ray computed tomography. In nine patients with LDA limited around the basal ganglia, perfusion defects were not identified by standard display alone, but six were found to have such defects by 3D surface display minus the covering upper structure. This study indicates that standard 3D surface display is useful in stereoscopically evaluating cortical defects without searching through a large number of single photon emission computed tomographic (SPECT) images. Moreover, 3D surface display minus the upper structure is effective to demonstrate defects within the brain.
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PMID:Clinical application of three-dimensional surface display in brain imaging with Tc-99m HMPAO. 205 91

Many patients suffer a stroke early after a transient ischemic attack, but the reason why is often unclear. We studied 12 patients with less than 75% stenosis of the internal carotid artery and a single hemispheric transient ischemic attack lasting less than 1 hour who had a normal neurologic examination 3-13 hours later and a normal computed tomogram 24-36 hours later. Single-photon emission computed tomography using technetium-99m HM-PAO less than or equal to 50 hours after the attack showed no abnormality in eight patients, but in the other four there was an area with 30-50% reduction in perfusion ipsilateral to the transient ischemic attack. Three of these four patients developed an ipsilateral infarct 3-7 days later, but none of the eight patients with normal single-photon emission computed tomograms had a stroke during the following weeks. No difference in therapy, risk factors, severity of internal carotid artery disease, or timing of the technetium-99m study could explain these findings. We suggest that some transient ischemic attacks, though clinically identical to others, may be associated with persisting focal hypoperfusion, which predisposes to early stroke.
Stroke 1990 Jan
PMID:Prolonged hypoperfusion and early stroke after transient ischemic attack. 230 Sep 90

Pulmonary embolism may cause pulmonary hypertension by mechanical obstruction, which might be amplified by vasoconstriction induced by serotonin released from the emboli. The purpose of the present study was to examine whether 5-HT2-receptors are involved in serotonin-induced pulmonary hypertension. Ketanserin was used as 5-HT2-serotonergic antagonist. In nine anesthetized mongrel dogs, the effect of serotonin infusions (10, 50, 100 micrograms/kg . min) on mean pulmonary artery pressure (PAP), pulmonary vascular resistance (PVR), cardiac output (CO), stroke volume (SV), cardiac contractility (dP/dtmax), heart rate (HR), and mean aortic pressure (PAO) was studied with and without treatment by ketanserin (20 and 100 micrograms/kg). Serotonin caused dose-dependent increase in PAP, PVR, CO, SV, and dP/dtmax. A dose of 20 micrograms/kg ketanserin did not affect hemodynamics significantly, whereas 100 micrograms/kg of the compound significantly reduced PAO, TPR, and left ventricular dP/dtmax. The serotonin-induced increases in PAP, PVR, dP/dtmax, CO, and SV were reduced significantly by 100 micrograms/kg ketanserin; the lower dose of ketanserin had only a slight blocking effect. Ketanserin blocks serotonin-induced pulmonary vasoconstriction partly, but it seems also to antagonize the positive inotropic effect of the monoamine.
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PMID:Effects of serotonin on the cardiopulmonary circulatory system with and without 5-HT2-receptor blockade by ketanserin. 241 62

Using technetium-99m-labeled hexamethylpropyleneamineoxime [( 99mTc]HM-PAO) and single-photon emission computed tomography, we measured changes in regional cerebral blood flow in a 58-year-old man during an attack of vertebrobasilar insufficiency. Angiography demonstrated compression of the left vertebral artery by the osteophytes of cervical spondylosis when the patient turned his head to the left. Measured in the orthostatic position while turning his head to the left during a typical attack of vertebrobasilar insufficiency, regional cerebral blood flow was significantly reduced in the left cerebellum and the right occipital region. Our study illustrates the capability of [99mTc]HM-PAO single-photon emission computed tomography to measure transient reductions in regional cerebral blood flow and to relate these changes to the pathophysiology of vertebrobasilar insufficiency.
Stroke 1988 Nov
PMID:Regional cerebral blood flow during an attack of vertebrobasilar insufficiency. 326 19

The uptake and retention in a 2 cm thick brain section was recorded serially by SPECT after i.v. injection of [99mTc]-d,l-HM-PAO (HM-PAO). In 16 patients, the fraction of the administered dose retained by the brain was 5.2 +/- 1%, showing a peak after 40-50s, then decreasing by 10% within the first 10 min and then by only 0.4% per hour. The image contrast was measured in each patient as the regional hemispheric asymmetry difference in percent of the highest value of the two regions. It decreased from 31% at 30-40 s to 25% at 10 min. At 24 h, a value of 19% was reached. Using the images obtained at 10 min after injection, a region to region comparison of the original and corrected HM-PAO images to the xenon-133 regional cerebral blood flow (rCBF) images was performed. Forty-four patients with stroke, epilepsy, dementia, basal ganglia disease, and tumors and control subjects were included in this comparison. The algorithm proposed by Lassen et al. was used to correct the original images for back diffusion of tracer (brain to blood); a good correlation very close to the line of identity between the corrected HM-PAO and xenon-133 data was obtained when using a conversion/clearance ratio of 1.5 and when the noninvolved hemisphere was used as a reference region (r = 0.86, p less than 0.0001). Serial arterial and cerebral venous blood sampling was performed over 10 min following i.v. injection of HM-PAO in six patients. An overall brain retention fraction of 0.37 +/- 0.03 (mean +/- SEM) was calculated from the data. An average CBF of 0.62 +/- 0.12 ml/g/min was determined on the basis of the Fick principle; this compared to a value of 0.59 +/- 0.09 ml/g/min (mean +/- SEM) measured by the xenon-133 inhalation method. The two sets of CBF values correlated linearly with a correlation coefficient of 0.97 (p less than 0.01). Inserting the average CBF value for the hemisphere as measured by the Fick principle into the algorithm described by Lassen et al. yields absolute rCBF values (ml/g/min) directly from the corrected HM-PAO images.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Quantitative measurements of cerebral blood flow using SPECT and [99mTc]-d,l-HM-PAO compared to xenon-133. 326 80

99mTc-HM-PAO was used to evaluate regional cerebral blood flow in a 26-year-old woman with Moyamoya disease. This patient had an 18-month history of recurrent neurologic deficits and had angiographic evidence of Moyamoya disease. She had used oral contraceptives and cigarettes, but had no other risk factors for stroke. Single photon emission computed tomographic images showed bilateral and asymmetric reductions in blood flow to anterior and lateral brain regions. These findings correlated better with clinical symptomatology and suggested more extensive brain involvement than did computed tomography.
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PMID:SPECT imaging of moyamoya disease using 99mTc-HM-PAO. Comparison with computed tomography findings. 326 30

The imaging of regional cerebral blood flow (rCBF) by 99mTc-d, 1 HM-PAO and SPECT is described. Its relevance to clinical syndromes, such as stroke, transient ischemic attacks, various forms of dementia, epilepsy, and subarachnoid hemorrhage, is reported.
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PMID:Evaluation of regional cerebral blood flow with 99mTc-d, 1 HM-PAO and SPECT. 333 36

A recently developed Tc-99m radiocompound, hexamethylpropyleneamine oxime (Tc-99m HM-PAO), exhibits favorable properties for regional cerebral blood flow study in man. The authors present a case of luxury perfusion syndrome observed in a 72-year-old patient with acute stroke and a right-sided hemiplegia, documented by planar scintigraphy and SPECT study in correlation with CT scan. The metabolic basis of this phenomenon is discussed and the usefulness of assessing regional brain perfusion by Tc-99m HM-PAO with conventional nuclear medicine equipment is underlined.
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PMID:Luxury perfusion syndrome in cerebral vascular disease evaluated with technetium-99m HM-PAO. 382 52


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